Daily Archives: July 2, 2014

“Much has been written about the possibility that Republicans could win control of the Senate in the 2014 elections. In fact, some prognosticators have given Republicans a better-than-even-money shot at taking the Senate back. If Republicans keep the House and garner the net six seats necessary to win a Senate majority, what does that mean for health policy and politics in the next Congress? In particular, what does it mean for the continued implementation and expansion of the Patient Protection and Affordable Care Act, otherwise known as Obamacare?
I hear these questions a lot, having served as the Republican health policy director for one of the key Senate health policy committees in 2006, the last time Republicans held a majority in both houses of Congress. The one thing I know for sure is that Republicans simply can’t pick up where they left off in 2006, but that answer is far from satisfying.
This much, we know: if Republicans regain both houses in January 2015, health policy in the 114th Congress will be dominated by a showdown between a Republican Congress and a Democratic White House over the future of Obamacare. The challenge for Republicans will be how to balance the desire of the party faithful for repealing Obamacare with the reality that President Obama would never permit it under his watch.”

“WASHINGTON — An independent audit of insurance exchanges established under the health care law has found that federal and state officials did not properly check the eligibility of people seeking coverage and applying for subsidies, the latest indication of unresolved problems at HealthCare.gov.
In a report to Congress on Tuesday, the inspector general for the Department of Health and Human Services, Daniel R. Levinson, said that the exchanges, which enrolled eight million people, did not have adequate safeguards “to prevent the use of inaccurate or fraudulent information when determining eligibility.”
Moreover, in a companion report, the inspector general said that the government had been unable to verify much of the information reported by people applying for insurance coverage and financial assistance to help pay premiums.”

“SEATTLE — Washington State’s health insurance exchange is looking to be an attractive marketplace for new health insurance carriers, according to an early analysis of insurer premium rate filings by McKinsey & Company.
Four new insurers have applied to sell individual policies in the state’s exchange next year, making Washington among the states with the highest number of new exchange entrants of the 12 states where preliminary 2015 rates have been filed, according to McKinsey. If insurance regulators approve the new carriers, Washington will have 12 insurers on the exchange in 2015, up from eight participating this year.
Washington’s not the only state attracting new health insurance business. Michigan also has four new exchange applicants, and five new carriers have applied in Indiana, the state so far with the highest number of new insurance carriers showing interest, according to the real-time tracking of state insurance department rate filings that McKinsey is doing.”

“The Supreme Court’s decision Monday saying that “closely held corporations” do not have to abide by the contraceptive coverage mandate in the Affordable Care Act may not give those firms the ability to stop providing that coverage after all.
More than half the states have “contraceptive equity” laws on the books that require most employers whose health insurance covers prescription drugs to also cover FDA-approved contraceptives as part of that package. Unlike the ACA, those laws do not require that coverage to be available without deductibles or co-pays.”

“The Supreme Court decision upholding Hobby Lobby’s ability to refuse to cover certain contraceptive services based on its owners’ religious beliefs has set off a wave of analysis of what the decision means. That will not be resolved anytime soon. But we do know what women think of the policy issue at the core of the case.
Overall, by a margin of 59% to 35%, women oppose the idea of letting companies deny coverage of contraceptives based on their owners’ religious beliefs. But women’s views on this issue–studied in the Kaiser Family Foundation Health Tracking Poll last month–differ by party, ideology and their religion.
White evangelical protestants, conservatives and women who are Republican are more supportive of Hobby Lobby’s position. Women who are liberal, Democrats, and protestant and Catholic are much more likely to oppose the company’s position.”

“The general sense about the Hobby Lobby decision handed down yesterday, very much suggested by the majority opinion itself, is that the ruling is highly significant for the particular matter at hand (the fate of the HHS mandate) but of limited significance for larger and broader questions beyond. It seems to me, however, that roughly the opposite may be the case.
In fact, the majority decision breaks some important ground on the general question of the corporate form in our civil society and its standing as a medium for the practice of our rights. But it leaves rather open the fate of the HHS mandate, by raising (without answering, as it was not at issue in this case) the question of whether the “accommodation” the administration has pursued regarding religious non-profits may be adequate both in their case and in that of for-profit corporations.”

“Today’s Supreme Court decision in the Hobby Lobby case should be seen as a clear and important victory for religious liberty. The majority opinion, written by Justice Samuel Alito, makes it clear that owners of closely held corporations, based on their sincerely held religious convictions, have the right to opt out of the so-called HHS mandate – the regulatory requirement that employers must include free contraceptives, sterilization procedures, and abortifacient products in their health-insurance offerings to workers. The plaintiffs in this case should be commended for having the courage to fight for their rights in court and for seeing their case through to victory despite the many obstacles they faced along the way.
But even in victory, it is hard to avoid the sinking feeling that having to fight at all over this issue is something of a defeat.”

“From the beginning, the Obama Administration made it clear that a critical part of the success
of the Patient Protection and Affordable Care Act (PPACA) was offering insurance to uninsured
individuals through a modern website that was simple and easy to use. To that end, the
Department of Health and Human Services (HHS) through the Centers for Medicare & Medicaid
Services (CMS) invested hundreds of millions of dollars in developing the HealthCare.gov
website (website) to make it the showcase of PPACA, since it would be the first tangible
product the American public would associate with the law. Both metaphorically and factually,
the website was designed to be the public face of President Obama’s signature achievement.
However, the Obama Administration failed to task any one individual or entity within HHS or
CMS with ensuring the success of the public face of Obamacare. While there were individuals
and entities tasked with building and coordinating many of the business level components of
the website, there was no central coordinator fully responsible for the development of the
website, and no single contractor had the authority to direct other contractors. Furthermore,
rather than delegate responsibility fully to HHS and/or CMS, the White House continually
meddled in technical decisions and put pressure on CMS officials to launch the website on time,
regardless of operability and security concerns. As a result, officials ignored countless red flags
to launch a website with thousands of defects. In the end, the launch failed miserably, crashing
on takeoff.”